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ABSTRACT: This prospective study examined the prognostic value of the Big Five personality model for changes in comorbidity patterns of emotional disorders both from a person- and trait-centered perspective. Moreover, it is investigated whether the predictive effect of personality can be attributed to symptom severity at baseline. We followed a cohort of 2566 persons (18-65 years) recruited in primary and specialized mental health care during two years. Personality dimensions at baseline were assessed with the NEO-FFI. The Diagnostic and Statistical Manual of Mental Disorders (4th ed.)-based diagnostic interviews with the CIDI allowed assessment of changes in comorbidity patterns of anxiety and depressive disorders over two years. Data were analyzed with latent class analysis (LCA) and latent transition analysis (LTA). LCA identified a four-class latent comorbidity class solution (Few Disorders, Fear Disorders, Distress Disorders, and Comorbid Fear and Distress Disorders) and a five-class latent personality class solution (High Resilients, Medium Resilients, Low Overcontrollers, Medium Overcontrollers, and High Overcontrollers). LTA showed that the likelihood of remaining in the same latent class was larger than that of transitioning to a less severe comorbidity class. Also, after correcting for symptom severity, medium and high Overcontrollers as well as participants with lower levels of conscientiousness were less likely to transition to a less severe comorbidity class. In particular, the individual trait of conscientiousness may be less dependent on current levels of anxiety and depressive symptoms and be a key pathoplastic or even predisposing variable in anxiety and depression and needs more theoretical and empirical study. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Journal of Abnormal Psychology 05/2012; · 4.86 Impact Factor
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Gitta H Lubke,
Jouke Jan Hottenga,
Raymond Walters,
Charles Laurin,
Eco J C de Geus,
Gonneke Willemsen, Jan H Smit,
Christel M Middeldorp,
Brenda W J H Penninx,
Jacqueline M Vink,
Dorret I Boomsma
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ABSTRACT: Genome-wide association studies of psychiatric disorders have been criticized for their lack of explaining a considerable proportion of the heritability established in twin and family studies. Genome-wide association studies of major depressive disorder in particular have so far been unsuccessful in detecting genome-wide significant single nucleotide polymorphisms (SNPs). Using two recently proposed methods designed to estimate the heritability of a phenotype that is attributable to genome-wide SNPs, we show that SNPs on current platforms contain substantial information concerning the additive genetic variance of major depressive disorder. To assess the consistency of these two methods, we analyzed four other complex phenotypes from different domains. The pattern of results is consistent with estimates of heritability obtained in twin studies carried out in the same population.
Biological psychiatry 04/2012; 72(8):707-9. · 8.93 Impact Factor
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ABSTRACT: Depressive and anxiety disorders often involve a chronic course. This study examined whether objective physical function is a predictor for the persistence of depressive and anxiety disorders.
The study sample consisted of 1206 persons with depressive and anxiety disorders at baseline. Hand grip strength and lung function were used as objective physical function measurements and were determined at baseline. Outcome variable was a 6-month depressive and/or anxiety diagnosis after 2 years of follow-up.
Lower hand grip strength predicted the persistence of depressive and/or anxiety disorders at 2-year follow-up (per SD increase: OR=0.82, CI: 0.69-0.99, p=0.04). Associations were consistent for depressive and anxiety disorder persistence. Poorer lung function was associated with the persistence of depressive disorders (per SD increase: OR=0.83, CI: 0.70-0.98, p=0.03) but not with anxiety disorders.
Follow-up was limited to 2 years.
Objectively measured poorer physical function predicted the persistence of depressive and/or anxiety disorders.
Journal of affective disorders 02/2012; 136(3):828-32. · 3.76 Impact Factor
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Iris M Heid,
Anne U Jackson,
Joshua C Randall,
Thomas W Winkler,
Lu Qi,
Valgerdur Steinthorsdottir,
Gudmar Thorleifsson,
M Carola Zillikens,
Elizabeth K Speliotes,
Reedik Mägi, [......],
Unnur Thorsteinsdottir,
Cornelia M van Duijn,
Kari Stefansson,
L Adrienne Cupples,
Ruth J F Loos,
Inês Barroso,
Mark I McCarthy,
Caroline S Fox,
Karen L Mohlke,
Cecilia M Lindgren
Nature Genetics 01/2011; 43(11):1164. · 35.53 Impact Factor
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ABSTRACT: Major depressive disorder (MDD) in elderly individuals is prevalent and debilitating. It is accompanied by circadian rhythm disturbances associated with impaired functioning of the suprachiasmatic nucleus, the biological clock of the brain. Circadian rhythm disturbances are common in the elderly. Suprachiasmatic nucleus stimulation using bright light treatment (BLT) may, therefore, improve mood, sleep, and hormonal rhythms in elderly patients with MDD.
To determine the efficacy of BLT in elderly patients with MDD.
Double-blind, placebo-controlled randomized clinical trial.
Home-based treatment in patients recruited from outpatient clinics and from case-finding using general practitioners' offices in the Amsterdam region.
Eighty-nine outpatients 60 years or older who had MDD underwent assessment at baseline (T0), after 3 weeks of treatment (T1), and 3 weeks after the end of treatment (T2). Intervention Three weeks of 1-hour early-morning BLT (pale blue, approximately 7500 lux) vs placebo (dim red light, approximately 50 lux).
Mean improvement in Hamilton Scale for Depression scores at T1 and T2 using parameters of sleep and cortisol and melatonin levels.
Intention-to-treat analysis showed Hamilton Scale for Depression scores to improve with BLT more than placebo from T0 to T1 (7%; 95% confidence interval, 4%-23%; P = .03) and from T0 to T2 (21%; 7%-31%; P = .001). At T1 relative to T0, get-up time after final awakening in the BLT group advanced by 7% (P < .001), sleep efficiency increased by 2% (P = .01), and the steepness of the rise in evening melatonin levels increased by 81% (P = .03) compared with the placebo group. At T2 relative to T0, get-up time was still advanced by 3% (P = .001) and the 24-hour urinary free cortisol level was 37% lower (P = .003) compared with the placebo group. The evening salivary cortisol level had decreased by 34% in the BLT group compared with an increase of 7% in the placebo group (P = .02).
In elderly patients with MDD, BLT improved mood, enhanced sleep efficiency, and increased the upslope melatonin level gradient. In addition, BLT produced continuing improvement in mood and an attenuation of cortisol hyperexcretion after discontinuation of treatment.
clinicaltrials.gov Identifier NCT00332670.
Archives of general psychiatry 01/2011; 68(1):61-70. · 12.26 Impact Factor
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ABSTRACT: Poorer physical function in patients with depressive or anxiety disorders has been reported, but is often measured by self-reports which may be biased by mood. This study examined the association between depression and anxiety and physical function using objective measures in a large cohort, and investigated which psychiatric characteristics are associated with physical function.
Baseline data from the Netherlands Study of Depression and Anxiety were used, including persons with current depressive and/or anxiety disorders (n = 1629) and healthy controls without lifetime diagnoses (n = 629). Psychiatric characteristics studied included type of disorder, duration, severity, age of onset, and antidepressant use. Hand grip strength and lung function were used as general objective measurements of physical function.
Women with depressive or anxiety disorders had significantly poorer physical function - both lower grip strength and lung function - compared to healthy controls, especially those with a late age of onset (≥ 40 years). Poorer lung function was present among the women using antidepressants, those with higher symptom severity, and those with depression compared to anxiety disorder. In men, depressive or anxiety disorder was associated with better lung function but not with hand grip strength.
Due to the cross-sectional design no causal relationships could be established.
In women, depressive or anxiety disorders were associated with objective indicators of poorer physical function. Since this association was most pronounced for later onset disorders, it suggests a larger role of physical function in depressive and anxiety disorders at later age.
Journal of affective disorders 12/2010; 131(1-3):193-9. · 3.76 Impact Factor
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ABSTRACT: Referral to mental health care was examined among persons with mental disorders with and without comorbid somatic conditions to determine whether certain conditions may make detection of mental disorders by primary care physicians more or less likely.
Receipt of mental health care in the primary and specialty care settings by respondents to the Netherlands Mental Health Survey and Incidence Study who had mood disorders (N=573), anxiety disorders (N=912), and substance use disorders (N=533) was examined, first broadly by any of 31 somatic conditions and then by each of the five most common conditions.
Broadly, those with anxiety disorders and a somatic condition were more likely to use care in both settings (adjusted relative risk ratios [RRRs]=1.75 and 1.58 for primary and specialty care, respectively), and those with substance use disorders and a somatic condition were more likely to use specialty care (RRR=2.15). More narrowly, use of specialty care by persons with mood disorders was three times as likely for those with rheumatoid arthritis or a digestive tract disorder (RRRs=3.04 and 2.92). For anxiety disorders, specialty care was more likely for those with chronic backache (RRR=2.14) or a digestive tract disorder (RRR=3.56). For substance use disorders, those with chronic backache were six times as likely to use specialty care (RRR=6.05) and those with a digestive tract disorder were three times as likely (RRR=3.09).
Poor somatic health in general seemed to increase the likelihood of use of mental health care for persons with anxiety or substance use disorders, but not for those with mood disorders. Having certain somatic conditions appeared to enhance recognition and treatment of three common mental disorders.
Psychiatric services (Washington, D.C.) 11/2010; 61(11):1119-25. · 2.81 Impact Factor
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Iris M Heid,
Anne U Jackson,
Joshua C Randall,
Thomas W Winkler,
Lu Qi,
Valgerdur Steinthorsdottir,
Gudmar Thorleifsson,
M Carola Zillikens,
Elizabeth K Speliotes,
Reedik Mägi, [......],
Unnur Thorsteinsdottir,
Cornelia M van Duijn,
Kari Stefansson,
L Adrienne Cupples,
Ruth J F Loos,
Inês Barroso,
Mark I McCarthy,
Caroline S Fox,
Karen L Mohlke,
Cecilia M Lindgren
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ABSTRACT: Waist-hip ratio (WHR) is a measure of body fat distribution and a predictor of metabolic consequences independent of overall adiposity. WHR is heritable, but few genetic variants influencing this trait have been identified. We conducted a meta-analysis of 32 genome-wide association studies for WHR adjusted for body mass index (comprising up to 77,167 participants), following up 16 loci in an additional 29 studies (comprising up to 113,636 subjects). We identified 13 new loci in or near RSPO3, VEGFA, TBX15-WARS2, NFE2L3, GRB14, DNM3-PIGC, ITPR2-SSPN, LY86, HOXC13, ADAMTS9, ZNRF3-KREMEN1, NISCH-STAB1 and CPEB4 (P = 1.9 × 10⁻⁹ to P = 1.8 × 10⁻⁴⁰) and the known signal at LYPLAL1. Seven of these loci exhibited marked sexual dimorphism, all with a stronger effect on WHR in women than men (P for sex difference = 1.9 × 10⁻³ to P = 1.2 × 10⁻¹³). These findings provide evidence for multiple loci that modulate body fat distribution independent of overall adiposity and reveal strong gene-by-sex interactions.
Nature Genetics 10/2010; 42(11):949-60. · 35.53 Impact Factor
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Elizabeth K Speliotes,
Cristen J Willer,
Sonja I Berndt,
Keri L Monda,
Gudmar Thorleifsson,
Anne U Jackson,
Hana Lango Allen,
Cecilia M Lindgren,
Jian'an Luan,
Reedik Mägi, [......],
Unnur Thorsteinsdottir,
Gonçalo R Abecasis,
Inês Barroso,
Michael Boehnke,
Kari Stefansson,
Kari E North,
Mark I McCarthy,
Joel N Hirschhorn,
Erik Ingelsson,
Ruth J F Loos
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ABSTRACT: Obesity is globally prevalent and highly heritable, but its underlying genetic factors remain largely elusive. To identify genetic loci for obesity susceptibility, we examined associations between body mass index and ∼ 2.8 million SNPs in up to 123,865 individuals with targeted follow up of 42 SNPs in up to 125,931 additional individuals. We confirmed 14 known obesity susceptibility loci and identified 18 new loci associated with body mass index (P < 5 × 10⁻⁸), one of which includes a copy number variant near GPRC5B. Some loci (at MC4R, POMC, SH2B1 and BDNF) map near key hypothalamic regulators of energy balance, and one of these loci is near GIPR, an incretin receptor. Furthermore, genes in other newly associated loci may provide new insights into human body weight regulation.
Nature Genetics 10/2010; 42(11):937-48. · 35.53 Impact Factor
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Hana Lango Allen,
Karol Estrada,
Guillaume Lettre,
Sonja I Berndt,
Michael N Weedon,
Fernando Rivadeneira,
Cristen J Willer,
Anne U Jackson,
Sailaja Vedantam,
Soumya Raychaudhuri, [......],
Nilanjan Chatterjee,
Ruth J F Loos,
Michael Boehnke,
Mark I McCarthy,
Erik Ingelsson,
Cecilia M Lindgren,
Gonçalo R Abecasis,
Kari Stefansson,
Timothy M Frayling,
Joel N Hirschhorn
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ABSTRACT: Most common human traits and diseases have a polygenic pattern of inheritance: DNA sequence variants at many genetic loci influence the phenotype. Genome-wide association (GWA) studies have identified more than 600 variants associated with human traits, but these typically explain small fractions of phenotypic variation, raising questions about the use of further studies. Here, using 183,727 individuals, we show that hundreds of genetic variants, in at least 180 loci, influence adult height, a highly heritable and classic polygenic trait. The large number of loci reveals patterns with important implications for genetic studies of common human diseases and traits. First, the 180 loci are not random, but instead are enriched for genes that are connected in biological pathways (P = 0.016) and that underlie skeletal growth defects (P < 0.001). Second, the likely causal gene is often located near the most strongly associated variant: in 13 of 21 loci containing a known skeletal growth gene, that gene was closest to the associated variant. Third, at least 19 loci have multiple independently associated variants, suggesting that allelic heterogeneity is a frequent feature of polygenic traits, that comprehensive explorations of already-discovered loci should discover additional variants and that an appreciable fraction of associated loci may have been identified. Fourth, associated variants are enriched for likely functional effects on genes, being over-represented among variants that alter amino-acid structure of proteins and expression levels of nearby genes. Our data explain approximately 10% of the phenotypic variation in height, and we estimate that unidentified common variants of similar effect sizes would increase this figure to approximately 16% of phenotypic variation (approximately 20% of heritable variation). Although additional approaches are needed to dissect the genetic architecture of polygenic human traits fully, our findings indicate that GWA studies can identify large numbers of loci that implicate biologically relevant genes and pathways.
Nature 09/2010; 467(7317):832-8. · 36.28 Impact Factor
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ABSTRACT: Major depressive disorder (MDD) is a moderately heritable disorder with a high lifetime prevalence. At present, laboratory blood tests to support MDD diagnosis are not available.
We used a classifier approach on blood gene expression profiles of a unique set of unmedicated subjects (MDD patients and control subjects) to select genes with expression predictive for disease status. To reveal blood gene expression changes related to major depressive disorder-disease, we applied a powerful ex vivo stimulus to the blood: incubation with lipopolysaccharide (LPS; 10 ng/mL blood).
Based on LPS-stimulated blood gene expression using whole-genome microarrays (primary cohort; 21 MDD patients, 21 healthy control subjects), we identified a set of genes (CAPRIN1, CLEC4A, KRT23, MLC1, PLSCR1, PROK2, ZBTB16) that serves as a molecular signature of MDD. These findings were validated using an independent quantitative polymerase chain reaction method (primary cohort, p = .007). The difference between depressive patients and control subjects was confirmed (p = .019) in a replication cohort of 13 MDD patients and 14 control subjects. The MDD signature score comprised expression levels of seven genes could discriminate depressive patients from control subjects with sensitivity of 76.9% and specificity of 71.8%.
We have shown for the first time that molecular analysis of stimulated blood cells can be used as an endophenotype for MDD diagnosis, which is a milestone in establishing biomarkers for neuropsychiatric disorders with moderate heritability in general. Our results may provide a new entry point for following and predicting treatment outcome, as well as prediction of severity and recurrence of major depressive disorder.
Biological psychiatry 07/2010; 68(2):179-86. · 8.93 Impact Factor
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ABSTRACT: Meynen G, Van Stralen H, Smit JH, Kamphorst W, Swaab DF, Hoogendijk WJG. Relation between neuritic plaques and depressive state in Alzheimer's disease.Background:To investigate for the first time in a prospective study the relationship between depressive state and the neuropathological hallmarks of Alzheimer's disease, using a scale for depressive symptoms in dementia, while controlling for clinical severity of dementia.Method:Within the framework of a prospective longitudinal study of depression in Alzheimer's disease, patients with dementia underwent a clinical evaluation every six months during the last years of their lives, using the Cornell scale for depression in dementia to assess depressive symptoms and using the Functional Assessment Staging scale to control for clinical severity of dementia. The brains of 43 Alzheimer patients were obtained. The last clinical evaluations prior to death together with post-mortem neuropathology measures were analysed.Results:We found a correlation between the Cornell scores and the sum score for the density of neuritic plaques in the entire cortex (p = 0.027), and even stronger in the temporal cortex (p = 0.012). The observed correlations were independent of sex, age of death, clinical dementia severity and duration of Alzheimer's disease.Conclusions:This study shows a positive relationship between depressive state at time of death and the presence of neuritic plaques in Alzheimer's disease, which is independent of the clinical severity of dementia.
Acta Neuropsychiatrica 10/2009; 22(1):14 - 20. · 0.58 Impact Factor
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Karol Estrada,
Michael Krawczak,
Stefan Schreiber,
Kate van Duijn,
Lisette Stolk,
Joyce B J van Meurs,
Fan Liu,
Brenda W J H Penninx, Jan H Smit,
Nicole Vogelzangs, [......],
Jules de Keijzer,
Albert Hofman,
Yurii S Aulchenko,
Ben A Oostra,
Claes Ohlsson,
Dorret I Boomsma,
Andre G Uitterlinden,
Cornelia M van Duijn,
Fernando Rivadeneira,
Manfred Kayser
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ABSTRACT: Northwestern Europeans are among the tallest of human populations. The increase in body height in these people appears to have reached a plateau, suggesting the ubiquitous presence of an optimal environment in which genetic factors may have exerted a particularly strong influence on human growth. Therefore, we performed a genome-wide association study (GWAS) of body height using 2.2 million markers in 10 074 individuals from three Dutch and one German population-based cohorts. Upon genotyping, the 12 most significantly height-associated single nucleotide polymorphisms (SNPs) from this GWAS in 6912 additional individuals of Dutch and Swedish origin, a genetic variant (rs6717918) on chromosome 2q37.1 was found to be associated with height at a genome-wide significance level (P(combined) = 3.4 x 10(-9)). Notably, a second SNP (rs6718438) located approximately 450 bp away and in strong LD (r(2) = 0.77) with rs6717918 was previously found to be suggestive of a height association in 29 820 individuals of mainly northwestern European ancestry, and the over-expression of a nearby natriuretic peptide precursor type C (NPPC) gene, has been associated with overgrowth and skeletal anomalies. We also found a SNP (rs10472828) located on 5p14 near the natriuretic peptide receptor 3 (NPR3) gene, encoding a receptor of the NPPC ligand, to be associated with body height (P(combined) = 2.1 x 10(-7)). Taken together, these results suggest that variation in the C-type natriuretic peptide signaling pathway, involving the NPPC and NPR3 genes, plays an important role in determining human body height.
Human Molecular Genetics 08/2009; 18(18):3516-24. · 7.64 Impact Factor
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ABSTRACT: Cortisol levels are increasingly often assessed in large-scale psychosomatic research. Although determinants of different salivary cortisol indicators have been described, they have not yet been systematically studied within the same study with a large sample size. Sociodemographic, health and sampling-related determinants of salivary cortisol levels were examined in a sample without potential disturbances because of psychopathology.
Using 491 respondents (mean age=43.0 years, 59.5% female) without lifetime psychiatric disorders from the Netherlands Study of Depression and Anxiety (NESDA), sociodemographic, sampling and health determinants of salivary cortisol levels were examined. Respondents collected seven salivary cortisol samples providing information about 1-h awakening cortisol, diurnal slope, evening cortisol and a dexamethasone (0.5mg) suppression test (DST).
Higher overall morning cortisol values were found for smokers, physically active persons, persons without cardiovascular disease, sampling on a working day or in a month with less daylight. In addition, the cortisol awakening response was significantly flattened for males, persons with cardiovascular disease, those with late awakening times and those with longer sleep duration. Diurnal slope was steeper in men, physically active persons, late awakeners, working persons, and season with less daylight. A higher evening cortisol level was associated with older age, smoking and season with more daylight. Cortisol suppression after dexamethasone ingestion was found to be less pronounced in smokers, less active persons and sampling on a weekday.
Sociodemographic variables (sex, age), sampling factors (awakening time, working day, sampling month, sleep duration) and health indicators (smoking, physical activity, cardiovascular disease) were shown to influence different features of salivary cortisol levels. Smoking had the most consistent effect on all cortisol variables. These factors should be considered in psychoneuroendocrinology research.
Psychoneuroendocrinology 07/2009; 34(8):1109-20. · 5.81 Impact Factor
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ABSTRACT: Although panic disorder is generally considered to be a chronic condition, little is known about the natural history of panic attacks and the factors predicting the prognosis of panic. It is expected that data derived from the community show more variation in the prognosis of panic and that subjects with less severe, 'subthreshold panic disorder' have a better prognosis.
Using a large, representative population-based study, the 2-year course of panic attacks and its predictors were investigated among 155 subjects with panic disorder and subthreshold panic disorder. Presence and frequency of attacks were studied using structured interviews. Putative risk-indicators of chronicity included socio-demographics, psychobiological, environmental, psychiatric and panic-related factors.
Thirty-nine percent of those with panic disorder and 17% of those with subthreshold panic disorder reported panic episodes during more than 75% of the observed time periods in the Life Chart Interview. Forty-three percent of those with panic disorder and 14% of those with subthreshold panic disorder reported over 24 attacks per 3-month period. Male gender, severity of panic and agoraphobia predicted a high proportion of time spent in panic episodes. Low self-esteem, limited positive life events and severity of panic predicted highly frequent attacks.
The sample size was small, thereby limiting statistical power. The reported outcome may have overestimated chronicity.
As was expected, the 2-year prognosis of panic was more varied than is often found in clinical studies. Although subthreshold panic disorder had a more favourable prognosis than full-blown panic disorder, a sizeable proportion of those with subthreshold panic disorder had an unfavourable prognosis.
Journal of affective disorders 06/2009; 121(1-2):30-8. · 3.76 Impact Factor
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Inga Prokopenko,
Claudia Langenberg,
Jose C Florez,
Richa Saxena,
Nicole Soranzo,
Gudmar Thorleifsson,
Ruth J F Loos,
Alisa K Manning,
Anne U Jackson,
Yurii Aulchenko, [......],
Michael Boehnke,
Inês Barroso,
Cornelia Van Duijn,
Josée Dupuis,
Richard M Watanabe,
Kari Stefansson,
Mark I McCarthy,
Nicholas J Wareham,
James B Meigs,
Gonçalo R Abecasis
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ABSTRACT: To identify previously unknown genetic loci associated with fasting glucose concentrations, we examined the leading association signals in ten genome-wide association scans involving a total of 36,610 individuals of European descent. Variants in the gene encoding melatonin receptor 1B (MTNR1B) were consistently associated with fasting glucose across all ten studies. The strongest signal was observed at rs10830963, where each G allele (frequency 0.30 in HapMap CEU) was associated with an increase of 0.07 (95% CI = 0.06-0.08) mmol/l in fasting glucose levels (P = 3.2 x 10(-50)) and reduced beta-cell function as measured by homeostasis model assessment (HOMA-B, P = 1.1 x 10(-15)). The same allele was associated with an increased risk of type 2 diabetes (odds ratio = 1.09 (1.05-1.12), per G allele P = 3.3 x 10(-7)) in a meta-analysis of 13 case-control studies totaling 18,236 cases and 64,453 controls. Our analyses also confirm previous associations of fasting glucose with variants at the G6PC2 (rs560887, P = 1.1 x 10(-57)) and GCK (rs4607517, P = 1.0 x 10(-25)) loci.
Nature Genetics 01/2009; 41(1):77-81. · 35.53 Impact Factor
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ABSTRACT: Depression frequently occurs in the elderly. Its cause is largely unknown, but several studies point to disturbances of biological rhythmicity. In both normal aging, and depression, the functioning of the suprachiasmatic nucleus (SCN) is impaired, as evidenced by an increased prevalence of day-night rhythm perturbations, such as sleeping disorders. Moreover, the inhibitory SCN neurons on the hypothalamus-pituitary adrenocortical axis (HPA-axis) have decreased activity and HPA-activity is enhanced, when compared to non-depressed elderly. Using bright light therapy (BLT) the SCN can be stimulated. In addition, the beneficial effects of BLT on seasonal depression are well accepted. BLT is a potentially safe, nonexpensive and well accepted treatment option. But the current literature on BLT for depression is inconclusive.
This study aims to show whether BLT can reduce non-seasonal major depression in elderly patients. Randomized double blind placebo controlled trial in 126 subjects of 60 years and older with a diagnosis of major depressive disorder (MDD, DSM-IV/SCID-I). Subjects are recruited through referrals of psychiatric outpatient clinics and from case finding from databases of general practitioners and old-people homes in the Amsterdam region. After inclusion subjects are randomly allocated to the active (bright blue light) vs. placebo (dim red light) condition using two Philips Bright Light Energy boxes type HF 3304 per subject, from which the light bulbs have been covered with bright blue- or dim red light- permitting filters. Patients will be stratified by use of antidepressants. Prior to treatment a one-week period without light treatment will be used. At three time points several endocrinological, psychophysiological, psychometrically, neuropsychological measures are performed: just before the start of light therapy, after completion of three weeks therapy period, and three weeks thereafter.
If BLT reduces nonseasonal depression in elderly patients, then additional lighting may easily be implemented in the homes of patients to serve as add-on treatment to antidepressants or as a stand-alone treatment in elderly depressed patients. In addition, if our data support the role of a dysfunctional biological clock in depressed elderly subjects, such a finding may guide further development of novel chronobiological oriented treatment strategies.
ClinicalTrials.gov identifier: NCT00332670.
Trials 02/2008; 9:48. · 2.02 Impact Factor
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ABSTRACT: In order to obtain repeated measurements of depression in an efficient and relatively inexpensive design, a mixture of face-to-face interviews and mail questionnaires was employed. The aims of the study were to examine mode effects of face-to-face interviews versus mail questionnaires on depression scores and to test potential interactions between mode of data collection and sex and age of the respondents. In the study sample, which at the outset consisted of 327 depressed and 325 non-depressed older adults (55–85 years) drawn from a larger random community based sample in the Netherlands, depression was measured in successive waves (cycles), using the Center for Epidemiologic Studies of Depression scale (CES-D). With mode of data collection and sex and age of the respondents as independent variables, differences in CES-D scores were analysed. The CES-D scores were higher when collected by mail questionnaires than when face-to-face interviews were used. No systematic interactions between sex and age of the respondents with mode of data collection were found. For the scores based on mail questionnaires, a transformation is proposed, resulting in scores that are comparable to those obtained by interviews. In studying depression in older adults, more cost-effective mail questionnaires may be used in addition to face-to-face interviews, provided that a transformation is performed before embarking on the analysis. Copyright © 1999 Whurr Publishers Ltd.
International Journal of Methods in Psychiatric Research. 03/2006; 8(2):102 - 109.
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ABSTRACT: The objective of this study was to examine whether low levels of oestradiol and testosterone are associated with impaired mobility, low muscle strength and the incidence of falls in a population-based sample of older men and women.
Cross-sectional population-based study, based on data of the Longitudinal Ageing Study Amsterdam (LASA), including 623 men and 663 women, aged 65-88 years.
Serum levels of oestradiol, testosterone, albumin and sex hormone-binding globulin (SHBG) were measured. Physical performance, functional limitations and muscle strength were assessed, and a follow-up on falls was performed prospectively within 3 years.
After adjustment for age, level of education, alcohol use, physical activity, chronic disease and body mass index (BMI), men in the highest quartile of the oestradiol/SHBG ratio had significantly higher physical performance scores than men in the lowest quartile (beta = 0.103). Serum levels of total testosterone were positively associated with muscle strength (beta = 0.085). Calculated bioavailable testosterone levels were positively associated with physical performance and muscle strength (beta = 0.128 and 0.109 respectively). No associations of oestradiol levels with mobility were seen in women. Levels of oestradiol and testosterone were not associated with falls.
It can be concluded that low levels of sex hormones were associated with impaired mobility and low muscle strength in men, but not in women. Levels of sex hormones were not associated with the incidence of falls neither in men, nor in women.
Clinical Endocrinology 09/2005; 63(2):152-60. · 3.17 Impact Factor
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ABSTRACT: To locate the genes that make a substantial contribution to variation in natural dizygotic twinning in humans, large-scale studies are needed. New studies should not stop at DNA genotyping, but collect material that allow gene-expression analysis, transcriptomics, proteomics and endocrinology. In this article we describe a pilot study to examine the feasibility, effectiveness and logistics of large-scale nationwide sample collection in Dutch families in which two or more sisters have given birth to spontaneous dizygotic twins. Pedigree data and addresses from family members of proband mothers were collected by telephone. Blood and urine samples were collected during a home visit, and handled in the afternoon. All participants were bled between 7 a.m. and 10 a.m. after overnight fasting. Blood samples of fertile women with a natural cycle were collected on the second, third or fourth day of their menstrual cycle. The effects of transportation and storage on blood quality, lipids, RNA with and without challenge, lymphocytes and other parameters were examined. Genomic DNA was isolated from blood and cells were immortalized using Epstein-Barr virus. In 78.6% of the women with a natural cycle blood samples were collected on the second, third or fourth day of the menstrual cycle. This percentage is likely to increase with the more dense geographical distribution of participants in the larger population. We conclude that the pilot study demonstrated the feasibility of this protocol to collect good quality of plasma, DNA, RNA and lymphocyte samples by home visits.
Twin Research 01/2005; 7(6):556-63.
